Key Benefits:
Decision of 9 December 2014, laying down rules on long-term care (long-term care decision)
We Willem-Alexander, at the grace of God, King of the Netherlands, Prince of Orange-Nassau, etc. etc. etc.
On the nomination of the State Secretary for Health, Welfare and Sport of 6 October 2014, attribute 673059-126985-WJZ,
Having regard to the Articles 2.1.1, fourth and fifth members , 2.2.1, second paragraph , 3.1.1, second paragraph , 3.1.3, first and second members , 3.2.1, fourth and fifth member , 3.2.3, fifth paragraph , 3.2.5, 1st and 2nd Member , 3.2.6, first and second members , 3.3.2, 8th paragraph , 3.3.3, first, fifth and sixth members , 3.3.5, second and fourth members , 4.1.1, fourth and sixth member , 4.2.4, second, third and fourth members , 5.1.4 , 7.1.2, third and fifth members , 8.1.1, second paragraph , 10.1.4, 1st Member , 11.1.4, 1st Member , and 12.4.8, first and second member, of the Act for long-term care , Article 60, second and third paragraphs, of the Law on Special Withdrawals in Psychiatric Hospitals , Article 2 and 56a of the health organisation Act , Article 91 of the Social Insurance Financing Act , Article 1, second paragraph , 5, second paragraph , and 6 of the Law Admission Care Institutions , Article 1, second paragraph, of the Quality Act care institutions , Article 11, third paragraph, of the Zorginsurance Act , Article 2, 2nd paragraph, of the Act uses civil service number in care , Article 8.1.8, second paragraph, of the Youth Act , Article 2.1.4, 4th paragraph, of the Social Support Act 2015 , the Articles 6.16 and 6.25 of the Income Tax Act 2001 , Article 91, first paragraph, of the Social Insurance Financing Act and Article 54 of the Act implementing organisation of work and income , Article 11, seventh paragraph, of the Social Employment Act , Article 1, second paragraph, of the Law of Promotion of Integrity Assessments by Public Administration , Article 13 of the Road Traffic Act , Article 29, third paragraph, of the Competition Act , Article 2, fifth paragraph, of the Framework Law on military pensions , Article 70c of the Housing Act , Article 11, 2nd paragraph, of the Rent Surcharge Act , Article 29, first paragraph, of the Personal Data Protection Act , Article 38a of the Code of Criminal Law ;
The Department for the Advisory Board of the State (Opinion of 20 November 2014, No. W13.14.0367/III);
Having regard to the further report of the State Secretary for Health, Welfare and Sport of 5 December 2014, attribute 697545-130582;
Have found good and understand:
For the purposes of this Decision and the provisions based thereon, the following definitions shall apply:
ADL assistance: throughout the etchette, direct invocation in general daily life operations in and around the ADL residence, intended for Article 1.1.1 of the Act , including alarm following an emergency call;
1 °. if there is an income tax or an income tax on the case of the peilyear: income tax due in respect of that year, Article 2.7 of the Income Tax Act 2001 , together with the public insurance premium for that year, as referred to in Article 4 (1). Article 9 of the Social Insurance Financing Act ;
2 °. in other cases: in that year the payroll tax referred to in the Article 20 of the Law on the payroll Tax 1964 , together with the public insurance premium provided for in that year, Article 9 of the Social Insurance Financing Act ;
protected live: protected living as intended in Article 1.1.1 of the Social Support Act 2015 ;
Budget plan: an overview of the use of a personal budget to be asked by the insured person or his legal representative;
Day: calendar day;
Own contribution: the contribution of the insured person to the cost of care;
Common care: normal, daily care that parents are supposed to offer to indwelling children;
save and invest: save and invest, meant in Article 5.2, first paragraph, of the Income Tax Act 2001 ;
1 °. if there is an income tax or an income tax on the case of the year in question: income given in the form of an income tax Article 21 (e) (1) of the General Law on State Taxation ;
2 °. in other cases: income data referred to in the Article 21 (e), (2) (2) of the General Law on State Taxation ;
modular package at home: modular package at home as intended in Article 3.3.2, first paragraph, part b, of the Act ;
Palliative terminal care: take care of the life phase in which the life expectancy of the insured person in the judgement of the treatment physician is less than three months;
Peillyear: second calendar year preceding the year in which the insured person brings his right to care;
Pensionable age: retirement age, intended in Article 7a, first paragraph, of the General old-age law .
Standard premium: amount, referred to in Article 1, first paragraph, section g, of the Care allowance Act ;
power: power, intended in Article 3.3.1.2 ;
complete package at home: integral and complete package at home as intended Article 3.3.2, first paragraph, part a, of the Act ;
Law: Long-term care law ;
Sack and changing money: amount, stated in Article 23, first paragraph, of the Participating Act ;
Care profile: a general characterisation of comparable health care needs or limitations in the same areas, with care, nursing, guidance or treatment targets corresponding to their nature, content and overall size;
Care allowance: concession as referred to in Article 1, first paragraph, part (e) of the Care Allowance Act ;
1 The notification provided for in Article 2.2.1, second paragraph, of the Act , shall be completed by means of a complete completed and by or on behalf of the insured signed form.
2 The Care Institute may establish one or more model notification forms.
1 Terence after the insured person is registered, the former executor shall provide him with a certificate of registration which may, if required, confer upon the insured person his right to make sure that he is entitled.
2 The Care Institute may establish a model for the certificate of registration referred to in the first paragraph. The Care Institute may lay down technical specifications to be met by a registration certificate if a magnetic strip card or a chip card is used.
If the Zorginstitute is to apply Article 35, third paragraph, of the Zorginsurance Act health insurers have been informed of his finding that an insured person is insured with two or more health insurers, is Article 2.2.1, first paragraph, of the Act , applicable only to the oldest tender in the case of a health insurer.
1 The invitation to tender to a Wlz executor, intended to Article 2.2.1, second and fourth paragraph, of the Act , shall be valid for one calendar year. Where an invitation to tender has been issued later than 1 January of one year, the invitation to tender shall be valid until 31 December of the following calendar year.
2 The invitation to tender referred to in paragraph 1 shall be extended by one calendar year at the end of each calendar year, unless the insured person has notified the Wlz executor in writing, before the date on which the period has expired, after the date of expiry of that period. period of expiry of the invitation to tender shall not be renewed.
3 The Wlz exporter may specify in writing a maximum period of two months which the insured person must take into account when making a communication as referred to in the second paragraph.
4 By way of derogation from the first and second paragraphs, a Wlz exporter terminates the registration of an insured person from the day on which the insured person is Article 2.2.1, first paragraph, of the Act the insured person has been applied in respect of the insured person or if it is not or is no longer permitted by the law in the case of the Wlz exporter.
1 The insured person who is designated for care shall be entitled to related care in the appropriate care profile of the insured person. Care profiles are established under a ministerial arrangement.
2 The insured person is entitled to more care than he is entitled under the first member, to the extent that more care is required to satisfy his need for care.
3 The nature, content and extent of the care shall be determined by the state of science and practice and, in the absence of such a measure, by what is relevant in the field in question as responsible and adequate care and services.
4 The right to care can be further settled by ministerial arrangement. The right to health care, including the right to greater care, as referred to in paragraph 2, may be subject to conditions and restrictions under ministerial terms. These restrictions may also cover common care and general practice.
1 The individual use of mobility aids specified in: Article 3.1.1, first paragraph, part (e) of the Act , includes the use of devices designated under ministerial arrangement for moving or letting them move:
a. In and around the institution or dwelling for the purpose of preserving or improving self-reliance, and
b. in the local environment for the purpose of engaging or maintaining social contacts.
2 Under ministerial arrangements, rules may be laid down concerning the use of devices, including rules as to whether they are required and obtaining prior consent from the Wlz exporter.
1 Lodgates as intended Article 3.1.1, first paragraph, part g, of the law shall contain for a maximum period of 104 hours per calendar year, to remain in a contracted institution.
2 If an indication decision is valid for part of a calendar year, the maximum number of times referred to in paragraph 1 shall be calculated by the number of weeks in that calendar year for which the indication decision is valid. multiply by two.
1 The reimbursement of a housing adjustment, which is to be found in Article 3.1.3 of the Act , charges for the provision of nature and nail-nail fixed adjustments to the dwelling necessary for the removal of ergonomie barriers in the provision of care in and directly around the property, excluding the cost of the provision of such equipment. from past due maintenance.
2 As a small-scale residential initiative as intended in Article 3.1.3, first paragraph, part a, of the law The following shall be considered to be a residential situation where:
a. At least three and a maximum of twenty-six residents receive a personal budget; and
b. residents are staying at one residential address as intended Article 1.1 of the Basic Registration Act , or at different residential addresses within a radius of a hundred metres, in which at least one common residence space is available for the purpose of engaging in joint activities.
3 By ministerial arrangement, the right to house accommodation adjustments may be further settled and subject to conditions to be laid down.
The insured person shall not be entitled to care under the law if he:
a. under his health insurance law is entitled to nursing and care as intended Article 2.10, first paragraph , or Article 2.12, of the Decision on health insurance , which is necessary in relation to palliative terminal care, unless such care is provided as a continuation of care under the law;
b. is a minor and is entitled to care under his health insurance because of complex somatic problems or because of a physical disability, as intended in Article 2.10, second paragraph, of the Act on health insurance ;
c. is a minor and is dependent on a reasonable limitation on care and support in a safe and trusted living and living environment, focused on education and where possible participating in social life as referred to in Article 3 (1). the care profile for living with counseling and care.
1 The application for an indictable decision may be made both orally and in writing.
2 Of an oral application submitted orally, the CIZ makes a report which contains at least the Article 4: 2 of the General Administrative Law Act was signed by the insured person and the data were recorded.
1 The preparation of an indication decision shall include in any case an examination of the insured person in person.
2 In assessing the extent to which an insured person has been designated for care, the CIZ involves the usual care and generally customary facilities.
3 By ministerial arrangement, rules may be laid down regarding the preparation of an indictable decision and the investigation. Those rules may also specify where the examination referred to in the first paragraph is not required.
If the insured person is dependent on care, indicate the indication decision:
a. the results of the preparatory study, Article 3.2.2, first paragraph ;
b. disorders, constraints, disorders or disabilities as a result of which he is dependent upon care;
c. the care profile on which he is designated;
d. to determine the characteristics of the insured person or of his care needed under a ministerial arrangement which may give rise to the award of more care as referred to in Article 4 (2) of the EC Treaty. Article 3.1.1, second paragraph ;
e. conditions and restrictions which are linked to the inset right to care;
f. the date from which he is entitled to care; and
g. the period of validity of the indication decision.
1 The CIZ shall take a decision on the application as soon as possible, but within six weeks of receipt of the application.
2 If an insured person is already receiving care due to special circumstances, an indication decision shall be taken no later than two weeks. If the insured person is designated by the Act on regular care under the Indication Decision, the Indication Decision shall return to the day on which the care is caught.
An indication decision shall apply for an indefinite period, unless the indicative decision belongs to a category of indicatori designated under a ministerial arrangement for which the validity of the measure is determined by the CIZ within the framework of the arrangement maximum duration.
1 The insured person of 18 years of age or older shall contribute to the costs of care.
2 The contribution is partly dependent on the income and the assets of the insured person and his spouse.
1 The power of a person shall be its capital base, as referred to in the second or third paragraph, the following assets of which shall be deducted:
a. upon application by the insured person, the amount of the amount of one-off benefits received by the insured person in the poll year or any previous year which Article 47 of the General Act, income-dependent schemes designated;
b. for the application of Article 3.3.2.3, first paragraph, part c , and Article 3.3.2.4, first paragraph , an amount of € 10,000 for the insured person who has not yet reached the retirement age and from € 10,000 for his spouse who:
1. the pensionable age has reached, or
2. the pensionable age has not reached and no contribution as referred to in Article 3.3.2.1, first paragraph , or Article 3.3.2.2, first or second paragraph , then Article 3.11, first paragraph , or Article 3.12, first or second paragraph, of the Implementing Decision Wmo 2015 is due,
except that the power is at least nil.
2 The equity base of a person is to save and invest, on the year of the year, or if, on the case of the pep year Article 5.2, second paragraph, of the Income Tax Act 2001 apply to the person, save and invest the part of the applicable joint foundation imputed to it, as referred to in that paragraph.
3 By way of derogation from the second paragraph, the equity base of a person shall apply to the person concerned. Article 3.3.2.3, second paragraph , Article 3.3.2.4, second paragraph , or Article 3.3.2.5 , save the basis to be expected and invest over the current year, or if Article 5.2, second paragraph, of the Income Tax Act 2001 is likely to apply to the person, to be expected to be allocated to him part of the applicable joint base to be expected and invest, as referred to in Article 5.2, second paragraph, of the Income Tax Act 2001.
4 The part of the amount referred to in paragraph 1 (a), which exceeds the property of the person, shall be applied to his spouse as a reduction.
1 The insured person is owed the own contribution to the CAK.
2 The insured person shall pay his own contribution within 30 days of the decision of the decision of the CCAK establishing whether and in what extent the insured person is liable for his own contribution, unless that decision indicates a later date.
3 The CAK is empowered to forgo claims under the Act of or to the insured with claims of or on the insured under the Act, the General Law Specific Health Costs , the Social support law or the Social Support Act 2015 .
4 The CAK makes use of the income given for the purpose of determining own contribution. Article 21, part (e) of the General Law on State Taxation and of other by the inspector referred to in Article 2 (b) of the General Law on State Taxation -Data provided.
1 A change in the marital status of the insured and the attainment of age for the purposes of this Decision by the insured person or his spouse shall be taken into account from the date on which the contribution was shall be determined, subject to the annual recalculation provided for in: Article 3.3.2.8, first paragraph , an insured person is considered to be a pensioner if he has reached pensionable age by 31 January of the calendar year to which the recalculation relates.
2 The insured person reports to the CAK changes as referred to in the first member.
1 The own contribution shall be established as soon as possible, but not later than 24 months after the date on which it is notified that the insured concern is provided by or under the law. The effective date of the period for which the own contribution is due shall not be set at a date which is more than 36 months before the date on which the decision in which the own contribution was adopted has been sent to the insured person.
2 If CAK has failed to determine its own contribution within the period referred to in the first paragraph, its own contribution may be fixed at a later date, except that the effective date of the period for which it is based is not the insured person must be paid, not be placed on a date which is more than 24 months prior to the day on which the decision in which the own contribution was fixed has been sent to the insured person.
1 The own contribution shall be revised no later than 24 months after the date of notification of the change in CAK. The effective date of the period for which the revised own contribution is due shall not be set at a date situated more than 36 months prior to the date on which the decision in which the own contribution was revised has been sent to the insured person.
2 The revised own contribution shall be set out as far as possible with the previously established contribution.
3 If CAK has failed to revise its own contribution within the period referred to in the first paragraph, its own contribution may be revised at a later date, it being understood that the effective date of the period for which the revised own contribution is to be the insured person must be paid, not set to a date which is more than 24 months prior to the day on which the decision in which the own contribution has been revised has been sent to the insured person.
4 In so far as the powers of review of the own contribution for a period have been repealed under paragraph 1, the own contribution previously established over that period shall be final.
1 By ministerial arrangement, the amounts are mentioned in the Articles 3.3.2.1, second paragraph , 3.3.2.2, third and fourth members , 3.3.2.4, second and fourth members , 3.3.3.1, 1st Member and Second Member , in so far as the amounts referred to in that paragraph are concerned per contribution period, and 3.3.3.2, second and fourth members , amended annually on the basis of the price index for household consumption. The calculated amounts shall be rounded down to a multiple of € 0,2. In the case of the annual application of the first sentence, the rounding out shall not be taken into account.
2 By ministerial arrangement, the amount is mentioned in: Article 3.3.1.2, first paragraph, part b , amended each year by reference to the index by which the amount, mentioned in: Article 5.5 of the Income Tax Act 2001 , each year is amended.
3 In the case of ministerial settlement, the amounts of the contribution of the contribution are mentioned in: Article 3.3.3.1, second paragraph , amended annually on the basis of the development of the minimum wage, Article 8, first paragraph, part a, of the minimum wage law and minimum holiday allowances .
1 The own contribution shall be a twelfth part of the contribution per month calculated according to: Article 3.3.2.3 , for:
a. the unmarried insured person residing in an institution;
b. The married insured persons who are both residing in an institution;
c. the married insured person residing in an institution and whose spouse is residing in a protected residence institution.
2 The contribution referred to in the first paragraph shall not exceed € 2,301,40 per month.
(3) In the case referred to in paragraph 1 (c), the insured person and his spouse shall, together, only pay their own contribution, calculated in accordance with the first and second paragraphs.
1 By way of derogation from Article 3.3.2.1 an own contribution per month shall be a twelfth part of 12,5% of the contribution rate calculated according to Article 3.3.2.4 for:
a. the unmarried insured during the first six months of residence in an institution;
b. The married insured persons together, as long as they have not been subject to a period of six months in respect of each of them;
c. the unmarried insured person, who must be insured or married, together who must provide for the cost of maintaining their own, married or foster children, provided that they are intended for the purposes of the General Child by-entry law right to benefit or to those children, to the extent that they have not yet reached the age of 27, student funding has been granted under the Law for the 2000 financial year ;
d. the unmarried insured or the married insured persons together if the Wlz executor is likely to consider that staying in the institution for the unmarried insured, for both or for either of the married insured persons, may be within half a year. the termination and return to society will be possible and will be achieved.
2 The own contribution shall also be calculated on the basis of one twelfth of 12,5% of the contribution per month. Article 3.3.2.4 for:
a. The married insured person residing in an institution receives a full package at home, a modular package at home or a personal budget, and whose spouse does not receive any care in kind or a personal budget;
b. The married insured persons together from whom one resides in an institution, receives a full package at home, a modular package at home or a personal budget, and the other a complete package at home, a modular package at home or a receive a personal budget;
c. receives the unmarried insured person who receives a full package at home, a modular package at home or a personal budget;
d. The married insured person who receives a full package at home, a modular package at home or a personal budget, and whose spouse resides in a protected residence institution, on the understanding that the insured person and his spouse together the own contribution is due only once.
3 The own contribution, referred to in the first and second paragraphs, shall be at least € 159.80 and not more than € 838,60 per month.
4 The own contribution will be reduced by € 136.80 per month for:
a. The unmarried insured person who receives a personal budget or a modular package at home;
b. The married insured persons who both receive either a modular package at home or a personal budget, or from whom one receives a modular package at home or a personal budget;
c. The unmarried insured person and the married insured person who receives a modular package at home or a personal budget if he or his spouse is a measure of employment, other than for protected living, or a personal budget, other than for protected living, based on the Social Support Act 2015 is receiving.
5 Parts a and b of the first paragraph shall not apply where:
a. an insured person who has the right to stay and the associated medically necessary medical care in connection with a mental disorder has ended under his health insurance since the person who is responsible for the care of Health insurance law maximum duration valid for such care has been reached; or
(b) the stay begins within six months of the termination of a stay in an institution for which the unmarried insured person or the married insured person, together with his or her own contribution as provided for in Article 3.3.2.1 was or were due, or
The stay begins within six months of the termination of a stay in a protected residence institution for which the unmarried client or the married clients together contribute as specified in the Article 3.11 of the Implementing Decision Wmo 2015 was or were.
6 For the calculation of the six-month period referred to in paragraph 5, periods of residence shall be aggregated in institutions, unless more than 60 days have elapsed between two such periods. The first sentence shall not apply to insured persons who stay in an institution for a period of up to two weeks every two months.
7 Upon application by the insured person, the own contribution shall not be payable if the insured person is entitled to benefits as referred to in the Article 23, first paragraph, of the Participating Act or if on the basis of Article 13, second paragraph, part a, of that Act does not receive benefit.
1 The contribution of the income in question Article 3.3.2.1, first paragraph The following shall be calculated as follows:
(a) the income of the unmarried insured insured against married insured persons shall be reduced by the income of the insured person, as a result of which the insured person shall pay tax due or deducted from the insured person;
b. to be deducted from the amount calculated pursuant to subparagraph a:
1 °. 15% of the net proceeds from work carried out in the previous calendar year of a wage or salary payment for sickness or benefit due to the payment of benefits Disease law or, if this is unknown or not available, 15% of the reasonably expected net proceeds of work carried out in the current calendar year, of a wage or salary payment due to sickness or benefit under the Health Act;
2 °. the amount applicable in the poll year for bag and changing money, premiums for a health care allowance adjusted for the care allowance, a deduction item that may be different for an insured person who has reached the retirement age and a insured person who has not yet reached that age or releases, by means of rules to be determined by ministerial rules;
3 ° on application by the insured person, the cash benefit in the case of the peil year under Article 14 of the Law Benefits Follow-up Victims 1940-1945 or on the basis of Article 20 of the Law on Benefits Citizen-War Victims 1940-1945 ;
(c) the amount calculated under subparagraph (b) shall be increased by 8% of the capital of the unmarried insured person, or 8% of the accumulated assets of the married insured persons.
2 Upon application by the insured person, the CAK, by way of derogation from the first paragraph, sets out parts a and c, the contribution income provisionally determined on the basis of reasonably expected income to be expected during the current calendar year, 8% of the income to be expected to be paid. expected power, and the expected tax on that calendar year, if application of the first paragraph, parts a and c, would lead to an average of less than the pocket and change money per month after the levy was cancelled, as in the current calendar year, as well as an amount related to the standard premium, plus the income dependent premium Health insurance law , referred to in Article 43, first paragraph, of the Zorginsurance Act , and less the health care allowance, as these amounts apply in the current calendar year. The contribution of the contribution thus calculated shall be divided by twelve to determine the contribution due per month.
3 The application referred to in paragraph 2 shall be made no later than three months after the end of the calendar year to which the application relates or not later than three months after the date on which the contribution, based on the contribution from the contribution, is to be taken into account in the the first paragraph shall be adopted.
(4) Where the second paragraph has been applied, the final determination shall be taken after the end of the year and after receipt of the final income and capital data. Where it is found that the second paragraph is not fulfilled, the definitive establishment shall be determined by application of the first paragraph.
5 Income tax which is taxed outside the Netherlands or is exempt from taxation under provisions of international law, is also taken into account as a true subject to the Dutch tax law. Upon application by the insured person, the tax payable shall be deducted from the tax due abroad.
1 For the calculation of own contribution, Article 3.3.2.2, first and second paragraphs ), the contribution rate of the income in respect of the annual income of unmarried insured persons, plus 8% of the unmarried insured person's assets, is 8% of the total income of the insured person. the accumulated faculties of the married insured persons. This contribution income is reduced by € 6,000, if an insured person receives a modular package at home or a personal budget.
2 Upon application by the insured person, the CAK, by derogation from the first paragraph, shall provisionally fix the contribution rate on the basis of the current year's income and assets, if reasonably foreseeable that the contribution is to be payable income in the current year at least € 2,559 will be lower than the contribution income referred to in the first member, or if the insured person ' s general assistance under the Participation Act is receiving.
3 The application referred to in paragraph 2 shall be made no later than three months after the end of the calendar year to which the application relates or not later than three months after the date on which the contribution referred to in the first paragraph is fixed.
(4) Where the second paragraph has been applied, final fixing shall be made after the end of the year and after receipt of the final income and capital data. If it is found that the contribution of the contribution in the current year is less than € 2,559 lower than the contribution rate referred to in paragraph 1, the final determination shall be made in accordance with the first paragraph.
5 Income tax which is taxed abroad or is exempt from taxation under provisions of international law, is also taken into account as a true subject to the Dutch tax legislation. Upon application by the insured person, the tax payable shall be deducted from the tax due abroad.
1 For the calculation of contribution income for the year in which an insured person or his spouse is first enjoying income, by derogation from Article 3.3.2.3, first paragraph, part a , or Article 3.3.2.4, first paragraph , based on the income expected to benefit the insured person or his spouse over the relevant calendar year, as well as the expected assets of that calendar year, reduced by the expected earnings over that calendar year tax due or withheld.
2 For the purpose of calculating contribution income for the year following the year in which an insured person or his spouse is enjoying income for the first time, by way of derogation from Article 3.3.2.3, first paragraph, part a , or Article 3.3.2.4, first paragraph , based on the income expected to benefit the insured or his spouse over the then current calendar year, as well as the expected assets of that calendar year, reduced by the expected earnings over that calendar year tax due or withheld.
3 For the calculation of the contribution income for the second year following the year in which an insured person or his spouse is enjoying an income for the first time, the amounts referred to in paragraph 2 shall be taken into account.
1 If Article 3.3.2.3, second paragraph , or Article 3.3.2.5, first or second paragraph In so far as it applies to the derogation provided for in Article 3.3.2.3, first paragraph, by way of derogation from Article 3.3.2.3, first paragraph, subparagraph (b), sub-part 2, shall be 12 times the amount applicable in the current calendar year for bag and changing money, the premiums to be paid in the current calendar year for health insurance adjusted for the care allowance and, where applicable, the general reduction for those who have not reached the retirement age at the same time as the general reduction for those who have reached the retirement age, as well as additional deductions referred to in Article 3.3.2.3, first paragraph, subparagraph (b), Subpart 2, have been deducted.
2 If Article 3.3.2.5, first paragraph , in so far as it concerns the derogation from Article 3.3.2.3, first paragraph , where the work is to be carried out in the course of the calendar year, the amounts referred to in Article 3.3.2.3, first paragraph, part b, shall be deducted from the part of the calendar year in respect of which the income is acquired. shall be taken
1 Where, in respect of unmarried or married persons, no data relating to income or basic income and investment are available, the own contribution shall be fixed at the minimum amount specified in the Article 3.3.2.2, third paragraph .
2 If, after the determination of own contribution, data relating to income or basic income or to invest or to change the basis of such data have been made available, it appears that the own contribution is either too high or too low. The CAK shall review its own contribution in accordance with the data available or of the change.
1 The amount of the own contribution shall be recalculated annually for the period of the first day of January to the thirty-one day of the following month.
2 By way of derogation from Article 3.3.2.7, first paragraph , where the income in the annual recalculation is still to be determined, as own contribution, the own contribution due in the last month in the previous calendar year.
1 The calculation of own contribution shall not take into account any absence from the institution, other than in relation to the termination of care.
2 For part of one month, the own contribution shall be equal to the fixed amount per month, multiplied by 12 times the number of days for which the contribution is due within that month and divided by 365.
3 Of the own contribution made for married insured persons, each of the spouses is due in proportion to everyone's share of the income.
The person who, coming from outside the Netherlands, has entered the Netherlands and as a result has become insured under the law, has no right of care for the first 12 months after the time when he settled in the Netherlands. if, at that time, he is already designated for the concerned care, or if the state of health of the person concerned had to be expected to be expected to be designated within half a year of the concerned care.
1 By way of derogation from Article 3.4.1 shall be equal to the insured person concerned who has entered the Netherlands within 12 years of his insurance under the law or the General Law Specific Health Costs was last ended or, in the case of a minor, the insurance under the Law or the Special Sickness Benefit Act of his legal representative was last ended, the period during which he was not entitled to the care provided for in Article 3.4.1 has, a number of months corresponding to the number of full years lying between the time of establishment in the Netherlands and the end of the last period of insurance under the Act or the General Law Special Medical Expenses.
(2) If the insured person referred to in paragraph 1 has been entitled to benefits in kind under a Regulation of the Council of the European Communities or of a Convention on social security in respect of benefits in kind in that period of 12 years from the Netherlands Where the Netherlands is a party, the number of full years during which he was charged that duty by the Netherlands shall be deducted from the period referred to in the first paragraph.
The Articles 3.4.1 and 3.4.2 shall not apply to:
a. aliens who lawfully reside in the Netherlands as intended by Article 8 (c) and (d) of the Aliens Act 2000 ;
(b) persons returning to land after having worked in the framework of development cooperation, in a field to be considered by our Minister for Foreign Trade and Development Cooperation as a development area, as well as the persons referred to above, accompanied by spouses, their own and married children, and their foster children;
c. persons who until the day prior to the time when they have become insured within the meaning of the Act or the General Health Insurance Act , reimbursement in respect of costs of care received on the basis of Article 3.1.2 of the Act of Import and Adaptation of the Sea Insurance Act or Article 1.22 of the Adaptation Decision Health Insurance Act .
In a decision to grant a modular package at home, the Wlz executor expresses the right to care of the insured person in modules, which are determined by ministerial arrangement by care profile.
Ministerial regulations allow for rules on calculating the maximum cost of a modular package at home, intended to be used in Article 3.3.2 paragraph 4 (b) of the Act and on the constituent elements of the costs which should not be taken into account.
Under ministerial arrangements, detailed rules may be laid down regarding the application, grant or refusal of a modular package at home or a complete package at home.
A personal budget shall be granted per calendar year.
1 The care office does not provide a personal budget if:
a. The insured person under an indication decision is designated by a care profile listed under ministerial arrangement;
b. the insured person refuses to discuss the budget plan with the care office or, after being called upon by the care office, does not appear;
c. the insured person did not complete and correct the application form set out by the care office;
The insured person, having regard to the particulars or documents supplied by the insured person, intends to spend the personal budget exclusively on the purchase of care from healthcare providers contracted by the Wlz exporter.
2 Under ministerial rules, rules may be laid down regarding the granting or refusal of a personal budget.
A personal budget shall not exceed a level to be determined by ministerial arrangement. The scheme may lay down detailed rules on the following:
a. Reduction of the amount for the items of treatment, capital charges, expenses for stay or other items;
b. multiplication of the amount for insured persons living in a small-scale housing initiative as intended in Article 3.1.3, second paragraph ,
c. the amount of the amount if, in addition to the personal budget, the insured person receives or wishes to receive a modular package at home as well.
1 The insured person enters into a written agreement with any healthcare provider or carer that he wishes to provide for the charge of his personal budget. A ministerial arrangement may stipulate that the contract shall conform to a model to be established by the Social Insurance Bank.
2 The insured person shall make the payments made by the Social Insurance Bank.
3 In the case of ministerial arrangements, rules shall be laid down concerning clauses or conditions to be included in the agreement and on the model referred to in paragraph 1. Such rules may also affect the dissolution of the contract if the person's budget is withdrawn or modified.
4 The agreement, referred to in paragraph 1, shall be subject to the approval of the care office and the Social Insurance Bank. Approval may be withheld only because of conflict with the law or the importance of the enforceability of the personal budget and of the budget management, as referred to in Article 4 (1) of the Treaty. Article 3.3.3, seventh paragraph, of the Act .
5 By way of derogation from the first and the second paragraph, the insured person may make payments himself to his/her personal budget in the case of charges related to transport as referred to in Article 4 (2). Article 3.1.1, first paragraph, part (f) of the Act for which the insured person has not entered into a written agreement.
1 At ministerial level, maximum rates are set for the provision of care which can be granted from the person responsible for the budget.
2 The rates referred to in the first paragraph shall be established for care provided by:
a. A healthcare provider, to the extent that it complies with in any case one of the requirements set out in the third paragraph; or
b. A healthcare provider other than a healthcare provider as referred to in part a or a carer.
3 In point (a) of the second paragraph, the following shall be considered if the care has been provided by:
1 °. an undertaking as referred to in Article 5 (a), (c), (d) or (e) of the Commercial Registry Act 2007 The activities of which, as evidenced by the entry in the Register of Trade, are intended to be Article 2 of that Act , consisting of, or consisting of, the provision of care,
2 °. an undertaking as referred to in Article 5 (b) of the Commercial Code Act 2007 The activities of which, as evidenced by the entry in the Register of Trade, are intended to be Article 2 of that Act , all or part of the provision of care and belonging to a self-employed person, without personnel, to whom a valid decision as provided for in the Article 3.156 of the Income Tax Act 2001 issued;
3 °. a person entered in the register, referred to in Article 3 of the Act on Professions in Individual Health Care , for the exercise of an appeal for the provision of care.
4 If Part (a) and (b) of the second paragraph apply simultaneously to a carer, the rate for carers referred to in paragraph 2 (b) shall apply.
1 The Social Insurance Bank shall make payments exclusively from the personal budget for the benefit of the insured person and shall administer the budget:
(a) in accordance with the provisions of the decision to grant the person-related budget referred to in Article 3.3.3, first paragraph, of the Act ;
b. In accordance with the valid agreement approved by the care office and the Social Insurance Bank, concluded by the insured person with the care provider or a staff member;
c. to the transfer of any pay levy, social security contributions and income dependent contributions on the basis of the Health insurance law ;
(d) for the purpose of obtaining funds from an amount of responsibility to be determined by ministerial arrangement for the provision of funds.
2 Under ministerial arrangements, rules on the cessation of payment by the Social Insurance Bank shall be laid down. In any event, such rules shall relate to payments in breach of legislation, contrary to decisions on the person's budget or in contraa with agreements referred to in the first paragraph.
In the case of a ministerial arrangement, rules may be laid down for the good performance of the person-related budget. These rules may also cover:
a. the assistance of a representative and a restriction on the circle of representatives;
(b) the content, revocation and amendment of the decision to grant and the decision establishing the personal budget;
c. the accountability and control,
d. the budgeting plan,
e. the implementation by the Social Insurance Bank of the budget management, including working staff.
1 To an insured person a charge is provided for expenses of care, if that care is granted outside the Netherlands and other than on the in Article 3.3.1, first or second paragraph, of the Act has been determined as a result of the following circumstances:
a. continuation of care already taken in the Netherlands: an insured person is entitled to such care for a maximum period of 13 weeks per calendar year outside the Netherlands;
b. continuation of palliative terminal care: by way of derogation from the provisions of subparagraph (a), a total period of not more than one year in the case of palliative terminal care;
c. Insufficient domestic health care: an insured person may, with the prior consent of the Wlz exporter, invoke outside the Netherlands for a period of not more than one year, if, in view of the state of health of the person concerned and the likely evolution of the insured person, the person concerned is liable to the necessary care within the Netherlands cannot or cannot be obtained in time, in which case the charges levied shall be reimbursed, provided that such costs are deemed to be appropriate in the Netherlands market conditions exceeds, it shall be remunerated several in so far as this is in accordance with the judgment of the Wlz exporter in reasonableness has been charged;
ed. stay outside the Netherlands for the exercise of an undertaking or profession or solely for reasons of study: an insured person residing outside the Netherlands in connection with the pursuit of business or occupation or not in employment or for other reasons of employment may continue as long as that condition continues and the person concerned has been insured under the law continues to care outside the Netherlands;
e. family members: part d shall apply mutatis mutandis to an insured person who is part of a joint household position as provided for in the Act with the insured person, as specified in that part;
f. Emergency care in the event of temporary stay: an insured person who, during a temporary stay outside the Netherlands, is required to provide immediate and necessary care, which may not be postponed until the time of the state of health of the person concerned and the likely evolution of the person concerned, The insured person has returned to the Netherlands, can receive this care for a maximum period of 13 weeks, which may be extended by the Wlz exporter if the insured person cannot be repatriated for medical reasons.
2 The charges levied shall be reimbursed up to a maximum of the costs which may be considered appropriate in the Netherlands market conditions, provided that the remuneration in the situation referred to in paragraph 1 (c) is higher. can be.
3 If the insured person is under Article 3.2.5 of the Act Where the care provided is a contribution to the costs, this contribution shall be fixed by the Wlz performer as far as possible in accordance with this Decision and deducted from the fee referred to in the first or second paragraph.
4 The first paragraph shall apply only where an independent doctor has established that and the extent to which the insured person is assigned to the care in question.
5 The insured person has no right of care or a reimbursement of the cost thereof during travel or temporary stay outside the Netherlands, if the care is provided to the insured person by an institution within the meaning of the Health care institutions Act .
1 The insured person may use a personal budget granted to him for a maximum period of 13 weeks per calendar year during stay outside the Netherlands for payment of care if such care is obtained as a continuation of already within the Netherlands. take care.
2 By way of derogation from paragraph 1, the insured person may, for a maximum period of one year during his stay, use a personal budget outside the Netherlands for the payment of continuation of palliative terminal care.
3 If the insured person stays outside the Netherlands for a period of more than six weeks and provides care workers who do not fall under the Dutch tax and social security legislation, the person allocated budget shall be calculated in accordance with the following formula:
The following definitions apply:
A: the number of weeks the insured person is staying within the Netherlands;
B: the number 52;
C: the person allocated to the insured person budget;
D: the number of weeks for insured persons outside the Netherlands;
E: the rate of acceptability established for the country concerned by the country concerned.
1 For the purpose of the assessment, Article 4.1.1, fourth paragraph, of the Act , the healthcare authority shall at least verify that the legal person seeking to execute the law complies with the following requirements:
a. the legal person belongs to a group as referred to in Article 24b of Book 2 of the Civil Code of which at least one health insurer is part;
(b) The Statute of the legal person shall comply with the requirements of Article 4.1.2 of the Act provided;
(c) the legal person has a clear, balanced and adequate organisational structure;
(d) the legal person shall have a clear, balanced and adequate distribution of tasks, powers and responsibilities;
e. the rights and obligations of the legal person are adequately committed;
f. the legal person shall have adequate reporting lines and an adequate system of information provision and communication;
(g) the management of the legal person is established in an insightful manner and is consistent with the work that the legal person as a Wlz executor will carry out or have carried out;
h. Given the expected management costs that the legal entity will incur as a Wlz performer, it will be possible to provide for a right-and efficient implementation of the law.
2 For the purpose of assessing the questions referred to in paragraph 1, the care authority shall submit its statutes and a programme of activities by the legal person.
3 The programme of operations shall include at least an estimate of the costs of the establishment of the administration and an estimate for the first three financial years of the other management costs.
4 The care authority is empowered to lay down detailed rules on the content of the programme of work.
1 The care authority determines whether the Wlz executor has ensured that the suitability and reliability of persons as intended in the system is Article 4.1.1, fifth paragraph, of the Act beyond doubt, on the basis of the intentions, acts and antecedents of these persons.
2 The Wlz executor takes for assessment of the suitability of a person as intended. Article 4.1.1, fifth paragraph, of the Act in any case, the training, work experience and competences of this person, as well as his knowledge of the financial sector in general and of the social functions of the Wlz performer and the risks involved in the activities of the WHO. in particular, on the basis of at least:
a. the curriculum vitae of this person;
b. the relevant valid diplomas of this person.
3 Takes the Wlz executor for assessment of the reliability of a person as intended. Article 4.1.1, fifth paragraph, of the Act In any case:
a. criminal records;
b. financial records;
c. surveillance training;
d. Fiscal administrative data; and
e. other antecedents as specified in Article 6 of the Prudential Rules Decision .
4 The Wlz executor obtains an insight into the intentions, acts and antecedents referred to in paragraph 1, on the basis of:
a. Data and intelligence provided by the person concerned;
b. Information obtained from references specified by the person concerned;
c. a statement of behaviour as referred to in Article 28 et seq. of the Law on Judicial and Criminal Justice ;
d. data from public sources;
e. information obtained from organisations of current or former professional persons of the person concerned;
f. data and intelligence, obtained from Dutch or foreign governmental bodies or from Dutch or foreign bodies designated by the government responsible for the supervision of financial markets or persons who are responsible for the supervision of financial markets or persons operate markets; or
g. information obtained from liquidators or directors relating to bankruptcies, sursurances, skillings, wind-liners or emergency arrangements involving the person referred to in the first paragraph.
5 If the data or intelligence, obtained in accordance with the fourth paragraph, give the Wlz exporter a further investigation, the Wlz executor may also obtain information and request data from any person or body other than the one mentioned in the That member. In that case, the Wlz exporter shall notify in writing the person concerned of:
a. the reason for the further investigation;
(b) the persons or bodies to whom further information or information will be sought; and
c. the nature of the details or information.
6 The Wlz executor shall take into account in the determination referred to in the first paragraph:
(a) the relationship between the conduct or behaviour underlying an antecedent and the other circumstances of the case;
(b) the interests which the law seeks to protect; and
c. the other interests of the Wlz executor and the person concerned.
7 The care authority shall use as far as possible the results of controls carried out by others when assessing, as referred to in the first paragraph, without prejudice to its competence to conduct its own investigation.
1 Regions referred to in Article 4.2.4, second paragraph, of the Act are:
-Groningen
-Friesland
-Drenthe
-Zwolle
-Twente
-Apeldoorn, Zutphen, and around ken
-Arnhem
-Nijmegen
-Utrecht
-Flevoland
-The Throw.
-North-Holland North
-Kennemerland
-Zaanstreek/Waterland
-Amsterdam
-Amstelland and the Meerlands
-South Holland North
-Hwland
-Westland Schieland Delfland
-Central Holland
-Rotterdam
-South Holland Islands
-Where land
-Zeeland
-West Brabant
-Central Brabant
-Northeastern Brabant
-Southeast Brabant
-North and Central Limburg
-South Limburg
-The Middle IJssel.
2 In the case of a ministerial arrangement, the municipalities belong to which region.
1 The administrative work carried out on the basis of Article 4.2.4 of the Act Designated Wlz executor shall be concerned with:
(a) providing the administration with regard to the care provided to the insured persons who reside in the region for which the Wlz executor is designated;
b. To promote the administrative contact between healthcare providers in that region on the one hand, and the CAK on the other.
2 For the purpose of carrying out the activities referred to in paragraph 1, the designated Wlz exporter shall have an adequate client-following business administration, in which a link can be made between the decisions of the Member States of the Wlz insured persons, the care provided by Wlz practitioners and the payments made by healthcare providers who have delivered this care.
A Wlz executor spends the execution of Article 4.2.1, first paragraph, parts a, and b, below 2 ° and 3 °, of the law Neither medially nor immediately out to a health care provider.
1 The Care Institute is pursuing joint care for the maintenance of electronic data traffic intended in the Article 9.1.6 of the Act , the following administration tasks from:
a. The setting of standards used in electronic data traffic; and
b. The management of the standards referred to in subparagraph (a).
2 The Care Institute promotes cooperation between the Wlz operators, healthcare providers, the CAK and the CIZ in the field of electronic data traffic.
3 In the case of ministerial arrangements, rules may be laid down on the functional security requirements for the preparation and identification of data and on the work of the Zorginstitute for the maintenance of electronic data traffic.
1 The CIZ assesses or an insured on the basis of Article 10.1.4. of the Act , eligible for ADL assistance.
2 The CIZ assesses whether an insured person is eligible for the forms of care, intended Article 11.1.5, first paragraph, of the Act .
3 The CIZ assesses whether an insured person is eligible for medically short-term stay as referred to in 11.1.5, third paragraph, (c) of the Act .
4 The CIZ determines entitlement to care for persons living abroad who are insured or subject to the application of Regulation (EC) No 1408/71. No 883/2004 of the European Parliament and of the Council of 29 April 2004 on the coordination of social security systems or their application pursuant to the Agreement on the European Economic Area or a convention on social security In the Netherlands during a stay in the Netherlands, the benefits of benefits in kind have the Netherlands legislation.
5 The decision referred to in paragraph 4 shall take into account the length of the period of residence of the care applicants in the Netherlands and shall have a maximum period of validity of six months, which may be extended once by a maximum of six months.
If appropriate, the CIZ shall request the care requestor referred to in the fourth paragraph to report in person for the purposes of the investigation. The travel and subsistence expenses associated with them shall be borne by the care requestor.
1 The CIZ, in so far as it relates to and further residence in a nursing or brother-in-law establishment as referred to in Article 1, first paragraph, point (h) of the Law on Special Withdrawals in Psychiatric Hospitals , designated as Commisssion for the purpose of Article 60, third paragraph, of that Act .
2 Before the CIZ makes a decision showing that inclusion and further stay in an institution referred to in paragraph 1 is necessary, the care requestor shall be provided, unless it has been established that he has the necessary willingness to include and continue to be included in the care stay, in writing and orally, that he may raise concerns about the inclusion and further stay.
3 If a decision as referred to in paragraph 1 is taken, unless it has been shown that the care requestor is willing to be willing until the entry and the further stay, the decision shall mention in that decision:
a. The nature of the mental faculties disorder;
b. the circumstances in which he/she cannot maintain himself outside an establishment as referred to in the first paragraph as a result of that disturbance; and
c. The manner in which he has been informed that he may raise concerns about the inclusion and further stay and his reaction to it.
The ban on mandating provision, which is intended to Article 7.1.2, fourth paragraph, of the Act , does not apply to organisations designated by Our Minister who, before 1 January 2015, carried out experiments on low-end indictable counting.
In the course of the discussion, Article 8.1.1, first paragraph, of the Act , between the health care provider and the insured person who wishes to receive his care in kind about the manner in which the insured wishes to establish his life and the support that the insured person will receive from the care provider will be provided in each Case attention paid to:
a. control of the insured person over the establishment of his life, including the involvement of carers and volunteers;
b. The ability to shower on a daily basis, timely assistance with toilet gait and to exchange incontinence material in a timely way;
c. adequate and healthy food and drink;
d. A clean and nursed enclosure;
e. a respectful bejesus, fitting with the self of the insured, and a safe and pleasant living atmosphere;
f. possibilities for the insured person to live and live in accordance with his religion or life belief;
g. a meaningful day filling and movement;
h. The ability to be in the outdoors on a daily basis; and
(i) development and development of the insured person including, in the event of participation in education, reconciliation with the school where the insured person has been notified or admitted.
1 The Institute of Care provides grants to organizations for the provision of ADL assistance to the extent that such organizations provide ADL assistance to insured persons living in ADL homes.
2 The organizations referred to in paragraph 1 shall provide ADL assistance to insured persons in accordance with a decision taken by the CIZ as referred to in Article 2 (2). Article 5.2.1, first paragraph .
3 In the ADL dwellings, care is provided to insured persons:
a. With a physical disability or somatic disorder or limitation;
b. Those assigned to a wheelchair accessible dwelling;
c. which are designated at least five hours of invocation ADL assistance per week; and
d. who are sufficiently socially self-reliant to live independently and to invoke self-sufficiency and to provide guidance.
4 By ministerial arrangement rules may be laid down regarding the grant of aid for ADL assistance, including its implementation, of what can be understood as ADL dwellings and control.
[ RESERVED]
The Administrative Decree Special sickness insurance shall be withdrawn.
The Decision waiting period special sickness insurance shall be withdrawn.
The AWBZ Healthcare Claims Decision shall be withdrawn.
The AWBZ Care Plan discussion decision shall be withdrawn.
The Contribution decision shall be withdrawn.
The Invitation to tender for special health insurance 1992 shall be withdrawn.
The Health Indication Decision shall be withdrawn.
After the entry into force of the law, Decision of the extension and restriction of the insured people's insurance policy 1999 Include: Article 2.1.1, fourth and fifth paragraph, of the Act .
This part has not (yet) entered into force; see the summary of changes
1 The insured person referred to in Article 11.1.1, sixth paragraph, of the Act or intended in the Articles 9.3a and 9.3b of the Scheme long-term care , contributes to the cost of care, where he owes a contribution as intended. § 3.2 of this Decision.
2 This Article shall expire with effect from 1 January 2017.
In the event of a ministerial arrangement, it is possible to lay down detailed rules for the proper implementation of this Decision with regard to the subjects covered by this Decision.
1 This Decision shall enter into force on a date to be determined by the Royal Decree, which may be adopted in a different way for the various articles or parts of such articles.
2 Article 8.1.3 works back up to and including the date when the law enters into force.
This decision is referred to as: Decision on long-term care.
Charges and orders that this Decision will be placed in the Official Journal by means of the note of explanatory note accompanying it.
Wassenaar, 9 December 2014
William-Alexander
The Secretary of State for Health, Welfare and Sport,
M.J. van Rijn
Issued the 18th of December 2014The Minister for Security and Justice,
I. W. Opstelten
